Physician Compare National (NPI:1548593239)

HEALTHCARE PROVIDER: KEVIN DALE LEWIS D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1548593239
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941588818
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161027000828
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEWIS
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	DALE
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WESTERN STATES COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	561 NE BELLEVUE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	BEND
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	977017696
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y